Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Multicenter Study
. 2012 Nov 27:13:158.
doi: 10.1186/1471-2369-13-158.

Validation of the Oxford classification of IgA nephropathy for pediatric patients from China

Weibo Le  1 , Cai-Hong Zeng, Zhangsuo Liu, Dong Liu, Qing Yang, Rui-Xia Lin, Zheng-Kun Xia, Zhong-Min Fan, Guanghua Zhu, Ying Wu, Hong Xu, Yihui Zhai, Ying Ding, Xiaoqing Yang, Shaoshan Liang, Hao Chen, Feng Xu, Qian Huang, Hongbing Shen, Jianming Wang, Agnes B Fogo, Zhi-Hong Liu
Affiliations
Multicenter Study

Validation of the Oxford classification of IgA nephropathy for pediatric patients from China

Weibo Le et al. BMC Nephrol. .

Abstract

Background: The Oxford classification of IgA nephropathy (IgAN) provides a useful tool for prediction of renal prognosis. However, the application of this classification in children with IgAN needs validation in different patient populations.

Methods: A total of 218 children with IgAN from 7 renal centers in China were enrolled. The inclusion criteria was similar to the original Oxford study.

Results: There were 98 patients (45%) with mesangial proliferation (M1), 51 patients (23%) with endocapillary proliferation (E1), 136 patients (62%) with segmental sclerosis/adhesion lesion (S1), 13 patients (6%) with moderate tubulointerstitial fibrosis (T1 26-50% of cortex scarred), and only 2 patients (1%) with severe tubulointerstitial fibrosis (T2, >50% of cortex scarred). During a median follow-up duration of 56 months, 24 children (12.4%) developed ESRD or 50% decline in renal function. In univariate COX analysis, we found that tubular atrophy/interstitial fibrosis (HR 4.3, 95%CI 1.8-10.5, P < 0.001) and segmental glomerulosclerosis (HR 9.2 1.2-68.6, P = 0.03) were significant predictors of renal outcome. However, mesangial hypercellularity, endocapillary proliferation, crescents, and necrosis were not associated with renal prognosis. In the multivariate COX regression model, none of these pathologic lesions were shown to be independent risk factors of unfavorable renal outcome except for tubular atrophy/interstitial fibrosis (HR 2.9, 95%CI 1.0-7.9 P = 0.04).

Conclusions: We confirmed tubular atrophy/interstitial fibrosis was the only feature independently associated with renal outcomes in Chinese children with IgAN.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Distribution of pathological features. Percentage of patients with each pathological feature.
Figure 2
Figure 2
Renal survival according to pathological variables. M mesangial hypercellularity score, E endocapillary hypercellularity, S segmental glomerulosclerosis or adhesion, T tubular atrophy/interstitial fibrosis, C crescents, N glomerulus necrosis.
See this image and copyright information in PMC

References

    1. D’Amico G. Natural history of idiopathic IgA nephropathy and factors predictive of disease outcome. Semin Nephrol. 2004;24(3):179–196. doi: 10.1016/j.semnephrol.2004.01.001. - DOI - PubMed
    1. Le W, Liang S, Hu Y, Deng K, Bao H, Zeng C, Liu Z. Long-term renal survival and related risk factors in patients with IgA nephropathy: results from a cohort of 1155 cases in a Chinese adult population. Nephrol Dial Transplant. 2012;27(4):1479–1485. doi: 10.1093/ndt/gfr527. - DOI - PubMed
    1. Haas M. Histologic subclassification of IgA nephropathy: a clinicopathologic study of 244 cases. Am J Kidney Dis. 1997;29(6):829–842. doi: 10.1016/S0272-6386(97)90456-X. - DOI - PubMed
    1. Radford MG Jr, Donadio JV Jr, Bergstralh EJ, Grande JP. Predicting renal outcome in IgA nephropathy. J Am Soc Nephrol. 1997;8(2):199–207. - PubMed
    1. Lee SM, Rao VM, Franklin WA, Schiffer MS, Aronson AJ, Spargo BH, Katz AI. IgA nephropathy: morphologic predictors of progressive renal disease. Hum Pathol. 1982;13(4):314–322. doi: 10.1016/S0046-8177(82)80221-9. - DOI - PubMed

Publication types

LinkOut - more resources